The 60% Medicare Rule: Navigating the Requirements for Rehabilitation Referrals

As the number of patients requiring inpatient rehabilitation escalates, nurse practitioners (NPs) must be familiar with the qualifying criteria and documentation outlined by the Centers for Medicare and Medicaid Services (CMS) 60% rule. Research shows that patients admitted to an inpatient rehabilitation facility have better functional outcomes than patients admitted to a lower level of care. This article will educate NPs on the 13 qualifying criteria outlined by CMS (CMS-13) in order to ensure clients receive the proper level of rehabilitation care.